A Unique, Co-Designed Family-Based Therapy for Marginalized Women with Opioid Use Disorder and Justice-Involvement

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Project Summary/Abstract Aaron Murnan, PhD, LMFT is a tenure-track assistant professor at University of Cincinnati's College of Nursing. His career goal is to become an independent clinician-scientist with expertise in co-designing novel interventions to address salient treatment needs among families disproportionately impacted by opioid use and justice-involvement, specifically women in the sex trade. The term `co-design' refers to a community-based participatory research methodology in which individuals with lived experience are engaged as study team members to lend their hands-on expertise and thoroughly participate in the intervention development process. Given well-documented risks associated with the sex trade and opioid use, as well as a lack of interventions prospectively designed to address challenges experienced by this population, the current study represents a critical next step towards promoting the health and well-being of women in the sex trade. The proposed five- year Mentored Patient-Oriented Research Career Development Award (K23) will provide Dr. Murnan a perfect opportunity to achieve his career goals through training in: 1) Community-Based Participatory Research; 2) ADAPT-ITT substance use intervention adaptation methodologies; and 3) conducting research within the criminal justice system. Dr. Murnan's proposed study aims to evaluate the feasibility and acceptability of co- designed family-based intervention offered as an adjunct to treatment diversion programming (offered through the criminal justice system) using a pilot RCT design. In Aim 1, participant family dyads (n=15 women paired with one supportive family member) will be recruited to explore intervention needs, motivations, and barriers related to participating in family-based intervention, as well as delivery preferences. This information will be used by the co-design team (individuals with lived experience, the PI, and other research personnel) to adapt a family-based intervention manual. For Aim 2, additional family dyads (n=60) will be recruited to participate in a randomized controlled trial in which they will be randomly assigned to one of two treatment arms: 1) co- designed family-based intervention + diversion treatment programming or 2) diversion treatment programming only. Feasibility, acceptability, and preliminary efficacy of both interventions will be evaluated (Aim 2). Dr. Melinda Butsch Kovacic, a leading expert in community-based participatory research, will serve as Dr. Murnan's primary site mentor. Dr. Butsch Kovacic in conjunction with his co-mentors (Drs. Jennifer Brown and Sarah Manchak) will provide him with necessary training in areas of community-based participatory research, substance use intervention adaptation methodologies, and conducting research within the criminal justice system, that will launch his independent research career as a clinician scientist with the requisite skills to conduct high quality intervention research to promote best outcomes among families disproportionately impacted by opioid use and criminal justice involvement.